Chiavacci, Eugene J

Chiavacci, Eugene J is an individual health care provider with primary practice located at 730 S Main St , Old Forge PA 18518-1459. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Chiavacci, Eugene J can be contacted via phone (570) 457-3300.

Contact Information

Primary practice address
730 S Main St Old Forge PA 18518-1459
Fax: (570) 457-4878
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD027185E Pennsylvania

Profile Details

NPI number 1992794630
LBN Legal business name Chiavacci, Eugene J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992794630 NPPES
Pennsylvania MEDICAID 00920915

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